The wide variety of massage lotions and oils available presents massage therapists and bodyworkers with wonderful opportunities to select products that can enhance the therapeutic experience. But what if the client has sensitive skin or allergies?
Client safety and comfort is always the primary concern, and a reaction to massage lotions, oils, essentials oils or fragrances should always be taken seriously. Familiarizing yourself with these cautions, including some questions to include on your new client intake form, and discussing potential sensitivities can help prevent unnecessary skin reactions or unpleasant side effects. It is important to remember that reactions to these products can appear mild at first, intensify over time or occur with great intensity all at once. A discussion with the client can identify potential problems before they occur.
Prevention is key
Asking clients if they have any known allergies on the client intake form is always a good idea. However, some clients may not be aware they have sensitivities or actual allergies. A good question to include on your client intake form is, “Have you ever developed a skin rash, swelling or redness after using a skin lotion, bath gel or soap?” Also ask, “Do any fragrances or smells make you sneeze, cough or have runny eyes or nose?” People who have a history of hay fever, asthma or food allergies may develop skin irritations (contact dermatitis) from the use of plant essential oils. Nut allergies are quite common, and a question regarding allergies or reactions to eating nuts should always be asked.
Nut allergies come in two categories: tree nut allergies and peanut allergy. The general public is far more aware of the presence of nuts in food due to increased labeling requirements for food items. Clients who have a food allergy to nuts may not make the connection that nut oils contain nut protein and may cause the same reaction. You can help educate your clients regarding nut oils and sensitivities or allergies. Tree nut allergies are common and potentially life threatening to some individuals. An individual can be allergic to one type, such as just tree nuts, or just peanuts or both.
Most tree nut oils including walnut, pecan, plum, almond, chestnut, hazelnut, macadamia birch or hickory contain enough of the specific allergenic protein to cause an allergic reaction. Tree nut oils that are cold pressed (unprocessed, raw, extruded or expelled) are not safe for a client with nut allergies. If you are considering using a nut oil-based product or using nut oil as a carrier agent for essential oils, it is critical to identify if your client has had sensitivity in the past to that oil, food or product.
Sensitivities and Reactions to Scents
Fragrance mix allergy
A single product, such as a massage lotion, may contain any number of fragrances. There are reportedly more than 5,000 different fragrances used in common products today. The good news is there are actually a small number of fragrances that are known to be sensitizers that may cause an allergic reaction. It is estimated that 1 to 2 percent of the general population is allergic to fragrance mix. However, the number of people who may experience skin sensitivity due to the use of fragrance in a product is larger and should be considered when selecting massage oils and lotions. Sensitivities to fragrances are often lifelong, and sensitivity may increase as the person ages due to repeated exposure to the fragrance.
Fragrance in essential oils
One of the most widely used components in perfumes, facial makeup and skin-care products, including massage lotions, is geraniol, which has the sweet odor of roses. Geraniol is used in rose and palmarose oil, geranium oil, lavender oil, jasmine oil and citronella oil. Geraniol is found in more than 250 essential oils. Because geraniol is so common, it has the potential to trigger skin reactions in sensitive individuals. If using essential oils with your clients, assess their potential sensitivity. All essential oils are too sensitive to be used directly on the skin, but the carrier oil selected needs to be considered as well. For clients with known sensitivities to nut oils, olive oil or grape seed may be a better choice.
What does fragrance-free mean?
Don’t be misled by thinking that because a produce is labeled “fragrance-free” it contains no artificial or natural fragrance.
Products that are labeled “unscented” or “fragrance-free” may actually contain fragrance additives. The term implies the product has no odor that can be detected—but this may be achieved by adding a masking fragrance that is used to cover up or hide the odor of the other ingredients in the product. Careful reading of the product ingredients may help to reveal what, if any, fragrance is used. For clients with fragrance sensitivities, “fragrance-free” products may cause a reaction if there are additives.
Menthol, capsaicin and peppermint
Massage lotions or oils which contain menthol, metholatim, capsaicin or peppermint (which contains menthol) can be additions to basic massage oil. Products designed to be analgesic (pain killing) or anti-inflammatory may contain one or more of these ingredients. If you select an oil or lotion containing these ingredients, do not use heating pads, warming mitts, booties or any application of a heat treatment, as burns may occur. Never microwave a product contain menthol, as it may splash and cause burns.
Each client’s individual preferences, skin condition and sensitivities should be considered when selecting the type of lotion or oil to use for a massage or treatment. Collecting a health history of potential skin sensitivities or allergies is necessary at new client intake and as an ongoing activity. Having a variety of oils and lotions available so you are able to select the best product for clients based on their personal history will ensure you can tailor your product selection for the individual. These steps, as well as following up with clients after your session, can help prevent skin irritations and reactions.
- Pong, Antony Ham, Tree Nut Allergies, accessed 10/17/08 from www.calagaryallergy.ca/Articles/English/treenuthp.htm
- DerNet NZ, accessed 10/03/08 from www.dermnetnz.org/dematititis/fragranceallery.html
- http://www.Nasal-Allergies.com (general info)
- Essential Oil Safety: Allergies and Allergic Reactions accessed 10/02/08 from www.karitegold.com/essential-oils-article-66.asp
Patti Biro is an educator with more than 25 years of experience in the design, development and planning of continuing professional education for health and wellness professionals. She is a NCBTMB-recognized provider of continuing education. Biro is the founder of Elder-ssage™: The Art and Science of Massage for the Aging Adult, which emphasizes the cross disciplinary use of massage for the older adult. She can be reached at firstname.lastname@example.org or on the Web at www.pattibiro.com.